New Poster - Pearl has Diabetes and I need help, please

Discussion in 'Feline Health - (Welcome & Main Forum)' started by bandp, Feb 2, 2021.

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  1. bandp

    bandp New Member

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    Feb 2, 2021
    Hello, everyone! My name is Becky and my cat Pearl was recently diagnosed with diabetes. She is a 17.5-year-old Turkish Angora and has been treated for IBD for the past 18 months with 5 mg prednisolone daily. She’s been small her whole life – ranging typically from 8-9 lbs. She’s been on a low-carb, high protein diet for 9 years – all wet food, never dry. All was going well until three weeks ago when Pearl began to get lethargic, lost interest in eating, but drinking and urinating a lot, and her spine (and then hips and shoulder blades) all of a sudden were completely visible. It all happened so quickly.

    I was hoping to get some help regarding a few questions, but here's the context in case that helps:

    The above of course prompted a vet visit. They found trace amounts of ketones in her urine, a blood glucose of 300, and a UTI. The vet ordered a fructosamine test for confirmation, but the test came back normal. The vet wanted me to check Pearl’s blood glucose again using the AlphaTRAK - Pearl *HATES* the vet, so the vet wanted me to try when she’d be relaxed and stress wouldn’t impact the read. I was unsuccessful getting a read despite repeated attempts. The vet came back over, got the ear poked, and it came back at 400. She said this confirms Pearl has diabetes and that we caught it early (which would account for the negative fructosamine test).

    In the 10 days since, I’ve been giving her 1 unit shots of Lantus, twice daily, 12 hours apart. Pearl is kind of doing better – some days more so than others – her appetite is up, she’s more alert (although still spending many days laying in bed), going back to some of her normal routine (she is very routine-oriented!). But despite this, she is looking skinnier and skinner. Not around her belly, but her spine – she looks like a stegosaurus! – her hips, her little legs. It’s like I’m watching her disappear.

    I’m so distressed right now and I was hoping someone could help me with a few questions:

    1. Is it feasible that she doesn’t have diabetes? The fructosamine test was normal, so could something other than diabetes cause high blood sugar?

    2. If the insulin is helping why is she still getting so skinny? This is the part that is most worrisome to me right now. She’s eating plenty and she isn’t actually losing weight! She’s been holding steady at about 7.6 lbs for three weeks – but it’s like her body shape is transforming. I can feel every bone in her back and her hips and shoulder blades jut out – her back legs have turned into little sticks. But her ribs are fine. Her belly is soft and bigger than normal (but maybe not? It could just look that way since the rest of her is shrinking?).

    3. 2. I know its a common question, but I’ve poked this poor cat’s ears so many times using the suggestions (warming her ears up, Vaseline, the sweet spot, etc.) and can never get enough for a read. My vet actually kind of poked and then ripped almost to get the blood. There has to be a way to do this that isn’t that, right?

    Sorry if this sounds panicky. I am panicking a bit here, honestly. Thank you all for any suggestions or feedback. It is greatly appreciated.

    Becky & Pearl
     
  2. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    Hello and welcome!

    I'm so sorry you're going through all this with Pearl, it sounds very stressful... Let me see if I can answer some of your questions.

    1) yes, it's possible that Pearl is only showing temporary high BG with the vet due to stress and just generally feeling yucky, especially with the normal fructosamine levels. Can't really say for certain though until you're able to get the home testing up and running. I will say that numbers in the 300-400 range are a bit higher than we usually see with just vet stress, and her improvement in symptoms since starting Lantus kind of goes against the "not diabetic" idea, but it's definitely something to keep a close eye on.

    2) this is very worrying. Unregulated diabetic cats can't utilize calories properly, so they can get skinny even while eating what seems like a lot, but I'd be worried there's something else going on somewhere to cause this. I'm glad you're in close communication with your vet about Pearl's health, hopefully if there is something else going on they'll be able to find it.

    3) One suggestion: make sure you're using large size (26 or 28 gauge) lancets. Often they include much smaller/thinner ones (30 or 31 gauge) with meters; those are fine to hang onto for later on after the ears "learn to bleed" by growing extra capillaries, but in the beginning you need the large size. These are sometimes labelled for "alternate site" testing.

    Relately, even your unsuccessful pokes are helpful, as they are helping to encourage the capillary growth. Keep at it, it does get easier eventually, usually!
     
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  3. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    I understand your panicking. I just went through it a little bit with my cat with kidney disease, and not eating. I also have just started to feel her back bone but not her ribs. She will be 17 this year. And her tummy feels fine.
    Are you able to get a copy of and post her blood work? We have folks here who can read them and help you to understand what they mean.

    Do you have ketone test strips? With trace ketones in the urine and a UTI and high blood glucose, that is a concern that ketones are developing and you do not want them to go any higher. I would test for ketones at least twice a day for now, until they are negative. Please post the results.

    Are you using a 28 gauge lancet? I found it easier to test on the insides of my kitty's ears as there is less hair and they are white hairs inside.
     
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  4. JL and Chip

    JL and Chip Well-Known Member

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    Dec 28, 2009
    Did the vet test her thyroid as well?

    If you didn’t get a copy of the blood work, I’d call the vet office and ask them to send you a copy. For thyroid, you’d be looking for something called “T4” or “Free T4 (by ED)” or something similar.

    What were her IBD symptoms that resulted in treatment with prednisolone? Was it diarrhea? How are those symptoms at the moment?

    Diabetes, IBD, hyperthyroidism ... they can all suck the weight off a cat despite eating well and it’s NOT uncommon to see several of those issues simultaneously.

    I encourage you to keep trying with the home testing of blood glucose. It will really help fill in some blanks and help guide next steps.
     
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  5. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Hi Becky,

    JL's just pipped me to the post in asking whether your vet has checked thyroid levels. With IBD in the picture I'd also ask the vet to check for possible maldigestion/malabsorption issues - e.g. tests for B12/folate levels, exocrine pancreatic insufficiency (fTLI), pancreatitis (Spec fPL) - since they, too, may contribute to weight loss.

    Helpful references:

    TAMU - Serum Cobalamin and Folate Levels

    TAMU - B12 Supplementation Protocol

    TAMU - TLI test

    IDEXX - Pancreatitis Treatment Guidelines

    ibdkitties.net - Importance of B12


    Mogs
    .
     
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  6. Critter Mom

    Critter Mom Well-Known Member

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    With regard to home testing, try warming the ear more and for much longer than you're doing at the moment.


    Mogs
    .
     
  7. bandp

    bandp New Member

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    Feb 2, 2021

    Thank you so much for these suggestions! Pearl did require Vitamin B12 shots when she was first diagnosed with IBD. So I will definitely check with the vet.

    Also, I tried warming her ear up even more this morning as you suggested and I finally got more blood - but it just seeped everywhere rather that forming a usable droplet! I will try again this afternoon. :)
     
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  8. bandp

    bandp New Member

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    Feb 2, 2021
    Hi, JL! Thanks for responding. I don't have the actual results (requesting today), but the vet told me her thyroid was normal.

    She had lost a lot of weight, was vomiting, and not eating much (no diarrhea) leading up to being diagnosed with IBD. It has been super well managed with the predisolone for the past 18 months - she's been back to her regular self! Except that her hair stopped growing - which the vet said can be due to long-term steroid use.

    I'm going to keep at it with the testing! After 10 days of failing at it, hopefully I'll get it right soon. Thanks again!
     
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  9. bandp

    bandp New Member

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    Feb 2, 2021
    Hi Dyana!

    Isn't it frightening to see them so skinny? I am worried I'll hurt her just petting her. She looks like a stegosaurus.

    I will request and post the blood work today. As for the ketone strips, do you have any brand recommendations? I haven't tried those yet.

    I bought the alphatrak - but I can't find anywhere on the packaging that indicates gauge size. A bit of googling makes me think it's 28, but I'm not certain!

    Thanks for responding!
     
  10. bandp

    bandp New Member

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    Feb 2, 2021
    Good morning! Thank you so much for taking the time to respond to me yesterday. I was feeling so overwhelmed and it is just helpful to hear from people. :)

    I'm trying to figure out the lancet size - I think it's 28, but I'm not certain. It's whatever comes with the Alphatrak? And I'm going to keep trying with the pokes. Pearl is getting less and less patient with it, so that's a challenge too! Hopefully those capillaries are growing.

    You're right - I hadn't thought about the fact that she has gotten a bit better with the Lantus. I was probably too focused on the normal fructosamine test.

    Thanks again!

    Becky
     
  11. Nan & Amber (GA)

    Nan & Amber (GA) Well-Known Member

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    Mar 19, 2016
    Even a smear of blood is a start! Sometimes, it's possible to collect enough on the back of a fingernail to be able to get the test done (easier without having to try to maneuver the meter to a restless cat's ear!).

    I don't have the AT so I can't say for sure, but almost always the lancets they include with meters are the smaller size (30 or 31 gauge). Definitely worth a try picking up some larger ones the next time you get a chance (you can get them in any human pharmacy with other diabetic supplies).

    It can be very frustrating at first, but you're doing everything right so far :).
     
  12. Dyana

    Dyana Well-Known Member

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    Dec 28, 2009
    The Walmart brand ReliOn ketone test strips are $5 for 50 test trips. Any pharmacy should have them. You need to follow the instructions and read the results at a set time.
    How many lancets did you receive with the AlphaTrak? I used to buy the One Touch UltraSoft lancets because they are 28 gauge.
     
    Last edited: Feb 5, 2021
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  13. Critter Mom

    Critter Mom Well-Known Member

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    Jun 16, 2014
    Alphatrak lancets are 28 gauge.


    Mogs
    .
     
  14. bandp

    bandp New Member

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    Feb 2, 2021
    I'll grab those and try them out. Thanks, Dyana!
     
  15. Dyana

    Dyana Well-Known Member

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    I'm sorry about that. I thought the copy and paste wasn't working. My computer is bad! :facepalm:
     
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  16. Critter Mom

    Critter Mom Well-Known Member

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    .

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    Mogs
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  17. Dyana

    Dyana Well-Known Member

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    Thanks Mogs. I have threatened to throw it in the swamp on numerous occasions. But, we don't have a swamp. :rolleyes:
     
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